New drug takes different approach to cure addicts

State looks to Warren Co. as model for using Vivitrol because it blocks brains ability to get high

Jan. 13, 2014

Sherry Moore, of South Lebanon, was addicted to a laundry list of drugs before she got help. / The Enquirer/Carrie Cochran

About Vivitrol

Vivitrol is the injectable form of the non-narcotic drug naltrexone, which was approved by the FDA for daily oral use in 1994 for the treatment of alcohol dependence. The tablet form of naltrexone was approved in 2006 for treatment of opiate addiction to prevent relapse. The FDA approved Vivitrol for monthly intramuscular injection in 2010. Vivitrol works in a different way than suboxone and methadone, which are narcotic opioid-replacement therapies. Vivitrol is an extended release formulation of naltrexone – an opioid antagonist, which binds to and blocks opioid receptors in the brain. The medication, which must be injected by a medical professional, is gradually released into the body at a controlled rate over a one-month time period. The drug blocks the brain’s ability to get high or drunk. Heroin users can’t get high even if they shoot up. Prescription opiate addicts won’t feel the effects of the narcotics. Alcoholics can’t get drunk and will lose muscle control as a side effect of drinking. Vivitrol is manufactured by Alkermes, which is headquartered in Dublin, Ireland, and has a plant in Wilmington, Ohio.

Warren County to be test ground for Vivitrol?

Warren County could become a pilot project that uses Vivitrol to keep addicted offenders from going back to prison. Common Pleas Judge Robert Peeler said his court has submitted a proposal to the Ohio Department of Rehabilitation and Correction to receive funding for monthly Vivitrol shots and treatment for 100 inmates whose crimes stem from addiction to heroin and painkillers. State officials contacted Peeler after The Enquirer published a story about Peeler offering treatments to offenders in his court who had private insurance or a way to pay for the expensive treatments. “They were interested in a pilot program that would be a model for the state,” said Peeler, who met with corrections officials and substance abuse professionals in Columbus. “They are trying to make an impact on the amount of people that are coming to prison, trying to reduce costs.” Peeler said Warren County could receive $1 million in grant money. The University of Cincinnati also has contacted the court about studying the program, he said. More details on the project were not immediately available from state corrections officials. A spokesman for the department said they are in active negotiations with Warren County.

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Sherry Moore walked into Mason Municipal Court high on cocaine and heroin.

She was afraid she would wind up in jail again even though the charge was minor – driving under suspension. She wound up with six months’ probation.

“I was so high. I was a mess,” Moore said of the Aug. 25, 2011, court appearance.

Angela Mustard recognized the bone-thin woman with ashen skin. Moore was a familiar face, having been a client in Mason’s probation department for the past eight years.

Those words set the gears in motion that would help Moore, now 53, overcome a 30-year addiction to a laundry list of drugs that included cocaine, prescription opioids and the heroin that sent her to prison for nine months two years earlier on a possession charge.

It set Moore up to receive a year’s worth of monthly injections of Vivitrol – the non-narcotic naltrexone – to help her kick her drug habit by reducing her cravings for heroin and painkillers. The drug also blocks an addict’s ability to get high on opiates, including heroin.

Because it is non-narcotic – unlike the drugs suboxone and methadone that are used for the same opiate addiction – some experts are touting Vivitrol as the best way to help addicts recover because they won’t get hooked on it.

Moore was one of the first offenders to be offered Vivitrol in a state-funded study in Warren County two years ago. She’s been clean since that day in August. First, she had to withdraw completely from heroin before she could receive the treatment.

The injectable drug, first approved in pill form in 1994 to help alcoholics stop drinking, helps opiate and heroin addicts to keep from relapsing by reducing their cravings. The risk of relapse among individuals with those addictions is extremely high – up to 90 percent over the course of a year without what is called medication-assisted therapy, research shows.

The drug has been studied at several prisons and jails across the country. Statistics from the Ohio Department of Mental Health and Addiction Services show that 36 percent of people treated with naltrexone stayed opiate-free, compared to 20 to 50 percent who used suboxone and 60 percent for methadone. Warren County had a 25 percent success rate with its jail study.

Warren County Common Pleas Court is now on the cusp of becoming the model in a pilot project to receive up to $1 million in state corrections money to offer free Vivitrol treatment to offenders. The project is aimed at keeping addicts from re-offending and winding up back in prison.

Warren County Judge Robert Peeler said the state contacted him last fall after The Enquirer published an exclusive story that Peeler was offering Vivitrol treatments to addicted offenders following the heroin overdose deaths of several defendants that Peeler had released early from jail. The Enquirer story was part of an ongoing series about the region’s heroin epidemic.

Peeler had expressed frustration that only offenders with private insurance could accept the treatment he was offering because the shots are costly at up to $1,000 apiece. That’s a $12,000 price tag for a year of treatment.

Mustard knew she needed more than probation to help Moore. She had to get her into jail, where inmates with addictions were being offered Vivitrol.

“Do you have anything in your purse?” Mustard asked Moore.

Moore handed over the suboxone she bought off the street and used to get high when she couldn’t get her hands on heroin.

“That was my way in,” Mustard said. “I knew Sherry. I knew she had a great heart, but I knew her addiction was greater than anything else she had at the time.”

Drug jump-started addict's turnaround

Mustard had Moore arrested on a felony drug possession charge and talked a prosecutor into reducing it to a misdemeanor so Moore could stay under the control of Mason’s probation department.

Moore spent six weeks in jail and walked out drug-free a week after receiving her first injection of Vivitrol behind bars.

Mustard said she put Moore on home incarceration and had her wear a GPS bracelet to ensure that she stayed put and away from her junkie lifestyle.

Moore, who lives in South Lebanon with a sister, made monthly trips for 11 more injections at Solutions Community Counseling and Recovery Centers in Lebanon and has finished the medication-assisted treatment while voluntarily continuing in substance-abuse counseling there.

A lifetime that started with doing cocaine at age 23 with her then-husband after their son was born has ended after three unsuccessful trips to rehab, a heroin overdose in 2009 and numerous trips to jail for thefts to support her habit.

Moore admits that Vivitrol isn’t a miracle drug. Addicts have to want to quit and be willing to change their lifestyle. That means giving up the drug-seeking friends of the past and receiving counseling to learn how to deal with the triggers of drug use, she said.

Russell Dern, executive director of Solutions, agrees.

“It’s not a substitute for the rest of it, which is changing your lifestyle, changing your habits, changing your peer group, developing sober supports,” Dern said. “You can’t just take the shot and expect that things will be OK.”

Vivitrol also has not miraculously changed Moore’s life. There’s plenty of good, but consequences of the past still linger, she said.

Moore said she is grateful to be able to help raise a grandson and to have a place to live. She has rekindled long-neglected relationships with her mother and other family members. Friends of the family gave her a car.

Moore’s success with Vivitrol and hard work at staying sober have won her an offer to serve on the Mental Health Recovery Services Board that oversees planning and funding for substance-abuse and mental-health programs in Warren County.

Moore now cleans a few houses to make money and spends the rest of her days caring for her 10-month-old grandson.

Moore’s addiction has cost her several factory and janitorial jobs over the years. She really didn’t care about working; finding heroin was a full-time job, she said.

“I wouldn’t do (heroin) again for nothing in this world,” Moore said. “My record is so bad I can’t find a job. I lost everything. It just takes everything you’ve got.” ■

I cover all things Butler and Warren County ranging from breaking news, development and government to courts, crime and watchdog stories. You can reach me at smclaughlin@enquirer.com